The authors present a case study of a 26-year-old woman who developed diabetes in early adolescence and who attended seven CAT sessions. They used phenomenology to analyze therapy transcripts, case notes, and a reflexive journal and extract the major themes. The client's identity had been overshadowed by the development of a "diabetic identity" that the client rejected. Poor adherence was linked to the rejection. Motivation to manage her diabetes changed during the CAT sessions once her identity was confirmed as being separate from her diabetes. The client was then able to integrate diabetes into her life.Psychological and psychosocial factors are linked in complex ways, both in the personal development of adolescents with diabetes and their transition to adulthood. Understanding the impact of diabetes on identity can enhance the effectiveness of therapeutic interventions with nonadhering clients.

The failure rate of in vitro fertilization (IVF) is around 75% per cycle. These unsuccessful attempts can provoke acute clinical depression and other problems. Although practitioners often recommend cognitive reappraisal, rather than avoidance, to cope with these difficulties, previous research has not established the psychosocial determinants of adaptive coping strategies. Arguably, resilience could encourage cognitive reappraisal, because resilient individuals feel confident they can overcome their emotions, whereas marital quality could prevent avoidance, because individuals feel secure enough to reflect upon their distress. Consequently, resilience and marital quality could facilitate recovery over time. To explore these possibilities, 184 women, all of whom had unsuccessfully completed IVF treatment, completed a questionnaire that gauged their levels of self-reported depression since their last IVF attempt as well as resilience and marital quality. Immediately after the unsuccessful attempt, resilience was inversely, whereas marital quality was positively, related to depression. However, within this cross-sectional sample after greater time had elapsed, marital quality became increasingly beneficial and was negatively associated with depression. These findings imply that resilience can curb the initial distress; in contrast, marital quality may enable individuals to reflect upon their trauma, initially amplifying distress but eventually facilitating recovery. Future research would benefit from longitudinal studies, illustrating whether resilience and marital quality at one time predict changes in distress at subsequent times.

sychotherapy research that compares one treatment with another has resulted in anomalies. First, treatments appear to be equivalent and second, therapist effects appear to be stronger than treatment effects. In order to make progress these anomalies need to be addressed. The ways in which research is proceeding can be conceptualised as following different paradigms, each one having convictions about what are the rules and standards for scientific practice.In particular, efficacy researchers advocate the gold standard to be the randomised controlled trial. Alternative and emerging paradigms for psychotherapy research are identified and briefly outlined. The problems and pitfalls of each one are summarised. It is argued that one of the paradigms, which is centered on understanding psychotherapy process and referred to in the paper as "back to the phenomena", offers the greatest potential for evidence-based psychotherapy practice. It is argued that future psychotherapy research should be based on theory-based process research. Psychodynamic psychotherapy process research is well established and examples of the findings of this type of research and their relevance to future research and practice are provided.

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